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Related Experiment Videos

[Gastrointestinal bleeding in children].

S Yokoyama1, J Soeda, T Fujimoto

  • 1Department of Surgery, Tokai University, School of Medicine, Isehara, Japan.

Nihon Geka Gakkai Zasshi
|September 1, 1989
PubMed
Summary
This summary is machine-generated.

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Diagnosing pediatric gastrointestinal bleeding involves considering patient age and bleeding characteristics. Endoscopic and imaging techniques help pinpoint bleeding sources, with common causes varying by age group.

Area of Science:

  • Pediatric Gastroenterology
  • Diagnostic Endoscopy
  • Medical Imaging

Context:

  • Gastrointestinal bleeding is a significant concern in pediatric patients.
  • Accurate diagnosis is crucial for effective management.
  • Tokai University Hospital data provides insights into pediatric bleeding causes and diagnostics.

Purpose:

  • To evaluate the site and nature of gastrointestinal bleeding lesions in pediatric patients.
  • To establish differential diagnoses based on bleeding characteristics and patient age.
  • To assess the utility of various diagnostic modalities for upper and lower gastrointestinal bleeding.

Summary:

  • Upper endoscopy is the primary diagnostic tool for upper gastrointestinal bleeding.
  • Lower gastrointestinal bleeding diagnosis utilizes sigmoidoscopy, colonoscopy, technetium scans, tagged red cell scans, and intraoperative angiography.

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  • Common causes include hemorrhagic disease, necrotizing enterocolitis, midgut volvulus (neonates); intussusception, internal hernia (infants); juvenile polyps, infectious diarrhea (children); duodenal ulcers, ulcerative colitis (adolescents).
  • Gastro-duodenal ulcers occurred across all age groups. Indomethacin-induced bleeding caused one neonatal death, but acute ulcers were typically managed conservatively.
  • Variceal bleeding secondary to portal hypertension post-Kasai procedure for biliary atresia was noted with increasing frequency.

    • Impact:

    • Provides a diagnostic algorithm for pediatric gastrointestinal bleeding.
    • Highlights age-specific etiologies of gastrointestinal bleeding in children.
    • Emphasizes the importance of tailored diagnostic approaches for pediatric bleeding.
    • Informs clinical practice regarding the management of various pediatric gastrointestinal bleeding causes.
    • Underscores the need for vigilance regarding specific complications like indomethacin-induced bleeding and post-Kasai variceal bleeding.